Surgical device including buttress material

ABSTRACT

The present disclosure provides a surgical stapling device and a method for joining tissue portions. The surgical stapling device includes a handle assembly and a tubular body portion supported on a distal end of the handle assembly having a staple cartridge assembly containing a plurality of surgical staples in an annular array. An anvil assembly is at a distal end of the stapling device and has a shaft for removably connecting the anvil assembly to the tubular body portion. The anvil assembly and tubular body portion are juxtaposed with respect to one another along the shaft and are arranged so as to be approximated with respect to one another. A support member extends from the tubular body portion towards the anvil assembly and a buttress material is supported by the support member and removably attached to the support member where the buttress material is disposed between the anvil assembly and the staple cartridge assembly.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a divisional and claims the benefit of and priorityto U.S. patent application Ser. No. 13/358,551 filed Jan. 26, 2012, theentire disclosure of which is incorporated by reference herein.

BACKGROUND

1. Technical Field

The present disclosure relates to buttress materials for use with asurgical stapling device and, more particularly, to a method andstructure for attaching a buttress material to a surgical staplingdevice for use in anastomosis procedures.

2. Background of Related Art

Staples have traditionally been used to replace suturing when joining oranastomosing various body structures such as, for example, the bowel orbronchus. The surgical stapling devices employed to apply these staplesare generally designed to simultaneously cut and seal an extendedsegment of tissue in a patient, thus vastly reducing the time and risksof such procedures.

Linear or annular surgical stapling devices are employed by surgeons tosequentially or simultaneously apply one or more linear rows of surgicalfasteners, e.g., staples or two-part fasteners, to body tissue for thepurpose of joining segments of body tissue together and/or for thecreation of anastomoses. Linear surgical stapling devices generallyinclude a pair of jaws or finger-like structures between which bodytissue to be joined is placed. When the surgical stapling device isactuated and/or “fired”, firing bars move longitudinally and contactstaple drive members in one of the jaws, and surgical staples are pushedthrough the body tissue and into/against an anvil in the opposite jawthereby crimping the staples closed. A knife blade may be provided tocut between the rows/lines of staples. Examples of such surgicalstapling devices are described in U.S. Pat. Nos. 4,354,628, 5,014,899and 5,040,715, the entirety of each of which is incorporated herein byreference.

Annular surgical stapling devices generally include an annular staplecartridge assembly including a plurality of annular rows of staples,typically two, an anvil assembly operatively associated with the annularcartridge assembly, and an annular blade disposed internal of the rowsof staples. Examples of such annular surgical stapling devices aredescribed in U.S. Pat. Nos. 5,799,857 and 5,915,616 to Robertson et al.,the entirety of each of which is incorporated herein by reference.

In general, an end-to-end anastomosis stapler typically places an arrayof staples into the approximated sections of a patient's bowels or othertubular organs. The resulting anastomosis contains an inverted sectionof bowel which contains numerous “B” shaped staples to maintain a secureconnection between the approximated sections of bowel.

For most procedures, the use of bare staples, with the staples in directcontact with the patient's tissue, is generally acceptable. Theintegrity of the tissue will normally serve to prevent the staples fromtearing out of the tissue and compromising the sealing before healinghas occurred. However, in some surgical operations, surgical supports,e.g., meshes or buttress materials, are employed by surgeons incombination with linear stapling devices to bridge, repair and/orreinforce tissue defects within a patient, especially those occurring inthe abdominal wall, chest wall, diaphragm, and other musculo-aponeuroticareas of the body. Examples of suitable surgical supports are disclosedin U.S. Pat. Nos. 3,054,406, 3,124,136, 4,347,847, 4,655,221, 4,838,884,5,002,551, and 7,942,890, the entirety of each of which is incorporatedherein by reference.

When the staples are applied in surgical procedures utilizing surgicalsupports (i.e., reinforcing material), the legs of the staple typicallypass from the cartridge jaw through a layer of the surgical support, andthrough the patient's tissue before encountering the anvil jaw.

While the surgical supports described above are used in conjunction withlinear surgical stapling devices, the need exists for annular supportstructures for use in conjunction with annular or circular surgicalstapling devices, for example, an end-to-end anastomosis stapler such asa Model “EEA™” instrument available from United States Surgical, aDivision of Tyco Health-Care Group, LP, Norwalk, Conn. and disclosed inU.S. Pat. No. 5,392,979 to Green et al.

One possible side effect of any end-to-end bowel anastomosis is itstendency to undergo stenosis, which can decrease the diameter of thelumen over time. Accordingly, the need exists for an annular surgicalstructure which operates in conjunction with any end-to-end, annular, orcircular anastomosis or stapling device and assists in keeping open thelumen of the anastomosed bowel or other tubular organ over time.

A need also exists for an annular support structure which operates inconjunction with any end-to-end, annular or circular stapling device toreduce the trauma suffered by the patient, reduce the instances ofleakage, reduce the instances of bleeding, and create a relativelystrong bond between adjacent body tissues.

SUMMARY

The present disclosure provides a surgical stapling device havingsupport members for supporting and attaching a buttress material theretoand a method of using the same.

In one embodiment, a surgical stapling device for joining tissueportions is disclosed. The surgical stapling device includes a handleassembly and a tubular body portion supported on a distal end of thehandle assembly having a staple cartridge assembly containing aplurality of surgical staples in an annular array. An anvil assembly isat a distal end of the surgical stapling device and has a shaft forremovably connecting the anvil assembly to the tubular body portion. Theanvil assembly and tubular body portion are juxtaposed with respect toone another along the shaft and are arranged so as to be approximatedwith respect to one another. A support member extends from the tubularbody portion towards the anvil assembly and a buttress material issupported by the support member and removably attached to the supportmember where the buttress material is disposed between the anvilassembly and the staple cartridge assembly.

In one embodiment the buttress material includes an attachment memberwhich extends from the buttress material to the support member and isattachable to the support member to removably secure the buttressmaterial to the support member. In another embodiment, the tubular bodyportion includes a plurality of support members and the buttressmaterial is removably attachable to the plurality of support members. Inanother embodiment, the support member is disposed in an openingextending at least partially through the tubular body portion. Inanother embodiment, the support member extends distally from the openingin an axial direction where a distal end of the support member issubstantially radially aligned with a distal face of the tubular bodyportion. In another embodiment, the buttress material is positionedproximate to a tissue contacting surface of the staple cartridgeassembly when the buttress material is attached to the support member.

In one embodiment the tubular body portion includes an elongate memberextending axially therefrom and defining a passage extending at leastpartially therethrough for reception of the shaft of the anvil assembly.In another embodiment, the support member is radially disposed betweenthe elongate member and the staple cartridge assembly. In anotherembodiment, the tubular body portion further includes a knife disposedbetween the elongate member and the tubular body portion. The knife isactuatable from a first proximal position to a second distal position tosever the tissue portions during firing of the surgical stapling device.In another embodiment, the support member is radially disposed betweenthe elongate member and the knife.

In another embodiment, a surgical stapling device for joining tissueportions is disclosed. The surgical stapling device includes a handleassembly and a tubular body portion supported on a distal end of thehandle assembly having a staple cartridge assembly containing aplurality of surgical staples in an annular array. An anvil assembly isat a distal end of the stapling device and has a shaft for removablyconnecting the anvil assembly to the tubular body portion. The anvilassembly and tubular body portion are juxtaposed with respect to oneanother along the shaft and are arranged so as to be approximated withrespect to one another. An elongate member extends from the tubular bodyportion towards the anvil assembly and includes an opening extending atleast partially therethrough for receiving the shaft of the anvilassembly. A buttress material is supported by the elongate member andremovably attached thereto where the buttress material is disposedbetween the anvil assembly and the staple cartridge assembly.

In one embodiment, the elongate member defines a substantially circularplatform at a distal end thereof and the buttress material is attachableto the circular platform. In another embodiment, the elongate memberdefines a proximal portion and a distal portion where the distal portionhas an outer diameter which is larger than an outer diameter of theproximal portion and the circular platform is disposed on the distalportion. In another embodiment, the inner diameter of the proximal anddistal portions are substantially the same. In another embodiment, thebuttress material is adhered to a distal end of the elongate member. Inanother embodiment, a distal end of the elongate member is substantiallyradially aligned with a distal end of the staple cartridge assembly.

A method of using buttress material with a surgical stapling device isalso disclosed. The method including the steps of positioning thebuttress material at least partially between an anvil assembly and acartridge assembly of the surgical stapling device and extending fromthe cartridge assembly to a support member of the surgical staplingdevice, securing the buttress material to the support member, receivingbody tissue between the anvil assembly and the cartridge assembly,grasping the body tissue between the anvil assembly and the cartridgeassembly, and firing the surgical stapling device to drive a pluralityof staples from the cartridge assembly through the buttress material andthe body tissue to thereby secure a first portion of the buttressmaterial to the body tissue.

In one embodiment, the step of firing the surgical stapling deviceincludes the step of transitioning a knife between a first proximalposition and a second distal position to sever the first portion of thebuttress material from a second portion of the buttress material whichis not secured to the body tissue, the second portion of the buttressmaterial remaining secured to the support member. In another embodiment,the support member is disposed radially inward of the cartridge assemblywith the knife disposed therebetween and the step of transitioning theknife includes the step of the knife severing the buttress materialextending between the cartridge assembly and the support member. Inanother embodiment, the second portion of the buttress material is aplurality of attachment members extending from the first portion of thebuttress material to the support member and the step of transitioningthe knife includes the step of the knife severing the plurality ofattachment members from the first portion of the buttress material.

BRIEF DESCRIPTION OF DRAWINGS

The accompanying drawings, which are incorporated in and constitute apart of this specification, illustrate embodiments of the disclosureand, together with a general description of the disclosure given aboveand the detailed description of the embodiments given below, serve toexplain the principles of the disclosure, wherein:

FIG. 1 is a perspective view of an exemplary annular surgical staplingdevice according to the present disclosure;

FIG. 2 is a perspective view of a buttress material in accordance withan embodiment of the present disclosure, for use with the annularsurgical stapling device of FIG. 1;

FIG. 3 is an enlarged perspective view of an anvil assembly and atubular body portion of the annular surgical stapling device of FIG. 1;

FIG. 4 is a top, plan view of the tubular body portion of FIG. 3,illustrating the support members of an embodiment of the presentdisclosure;

FIG. 5 is a top, plan view of the tubular body portion of FIG. 3,illustrating the buttress material supported on the support members;

FIG. 6 is a schematic, longitudinal, cross-sectional view of the anvilassembly and tubular body portion of FIG. 3, as taken through 6-6 ofFIG. 3, illustrating the buttress material supported on the supportmembers;

FIG. 7 is a schematic, perspective cut-away view of a tubular bodyportion of an annular surgical stapling device according to anotherembodiment of the present disclosure;

FIG. 8 is a schematic, longitudinal, cross-sectional view of the annularsurgical stapling device of FIG. 7, as taken through 8-8 of FIG. 7;

FIG. 9 is a top, plan view of the tubular body portion of FIG. 7,illustrating a buttress material attached to a central shaft of thetubular body portion;

FIG. 10 is a plan view of a buttress material, according to anotherembodiment of the present disclosure, for use with an annular surgicalstapling device;

FIG. 11 is a top, plan view of the buttress material of FIG. 10,illustrating the buttress material supported on the support members of atubular body portion of the annular surgical stapling device;

FIG. 12 is a schematic, longitudinal, cross-sectional view of theannular surgical stapling device of FIG. 3, illustrating the buttressmaterial of FIG. 10 supported on the support members of the tubular bodyportion with tissue disposed between the buttress material and the anvilassembly of the annular surgical stapling device; and

FIG. 13 is a perspective view of the intestinal area of a patient,illustrating a method of positioning the annular surgical staplingdevice of FIG. 1 to connect the anvil assembly to the tubular bodyportion.

DETAILED DESCRIPTION OF EMBODIMENTS

Embodiments of the presently disclosed annular surgical stapling devicewill now be described in detail with reference to the drawing figureswherein like reference numerals identify similar or identical elements.As used herein and as is traditional, the term “distal” refers to thatportion which is furthest from the user while the term “proximal” refersto that portion which is closest to the user.

Referring initially to FIG. 1, an annular surgical stapling device foruse with a buttress material is disclosed herein and is generallydesignated as 10. Surgical stapling device 10 includes a handle assembly12 having at least one pivotable actuating handle member 14, and anadvancing member 16. Extending from handle member 12, there is provideda tubular body portion 100 which may be constructed so as to have acurved shape along its length. Body portion 100 terminates in a staplecartridge assembly 102 which includes at least one annular array ofstaple receiving slots 104 having a staple (not shown) disposed in eachone of staple receiving slots 104. For example, staple cartridgeassembly may include one, two, or more than two annular arrays of staplereceiving slots 104.

Staple cartridge assembly 102 may be fixedly connected to the distal endof tubular body portion 100 or may be configured to concentrically fitwithin the distal end of tubular body portion 100. Typically, staplecartridge assembly 102 includes a staple pusher (not shown) including aproximal portion having a generally frusto-conical shape and a distalportion defining two concentric rings of peripherally spaced fingers(not shown), each one of which is received within one of the respectivestaple receiving slots 104.

Typically, a knife (not shown), substantially in the form of an open cupwith the rim thereof defining a knife edge, is disposed within staplecartridge assembly 102 and mounted to a distal surface of a staplepusher (not shown). The knife edge is disposed radially inward of thepair of annular arrays of staples. Accordingly, in use, as the staplepusher is advanced, the knife is also advanced axially outward.

Positioned distally of staple cartridge assembly 102 there is providedan anvil assembly 200 including an anvil member 202 and a shaft 204operatively associated therewith for removably connecting anvil assembly200 to a distal end portion of stapling device 10.

Reference may be made to U.S. Pat. No. 5,915,616 to Viola et al., theentire contents of which are incorporated herein by reference, for adetailed discussion of the construction and operation of annularstapling device 10. U.S. Pat. No. 5,915,616 to Viola et al. is herebyincorporated by reference herein, in its entirety.

Referring now to FIGS. 1, 3, 4, 5 and 6, body portion 100 of staplingdevice 10 includes a plurality of support members 108 extending from acentral shaft 110. One or more support members 108 are adapted tosupport and secure a buttress material 300 adjacent to or proximate to atissue contacting surface 106 of staple cartridge assembly 102. As seenin FIG. 6, each support member 108 includes a base portion 112 extendingradially outward from a proximal portion 114 of central shaft 110 and anattachment portion 116 extending distally from base portion 112. It iscontemplated that each base portion 112 may alternatively extend fromcentral shaft 110 at any position along its length up to and including adistal end 118 of central shaft 110, where, for example, each baseportion 112 may extend from central shaft 110 at a middle portion 120 orat distal end 118. It is also contemplated that each support member 108may extend directly from tubular body portion 100 rather than centralshaft 110.

It is contemplated that each attachment portion 116 may be radiallyspaced from central portion 110 or may be adjacent to or abuttingcentral portion 110 where no base portion 112 would be necessary. Anynumber of support members 108 may be provided at various positionsradially about central portion 110, such as, for example, one, two, fouror more support members 108. Support members 108 may be positionedradially about central shaft 110 in any configuration where, forexample, each support member may be offset by ninety degrees (See FIGS.4 and 5) or may be offset by more degrees or less degrees as desired. Itis also contemplated that the offset between a first adjacent pair ofsupport members 108 may be greater or less than the offset between asecond adjacent pair of support members 108. As seen in FIGS. 4 and 5,attachment portions 116 of each support member 108 may be positioned ata different spacing from central portion 110 and multiple supportmembers 108 having attachment portions 116 with different spacing fromcentral portion 110 may be included at the same time.

Base portions 112 of support members 108 may define a linear shape ormay instead define an arcuate shape where, for example, a portion ofbase portions 112 curve distally away from central portion 110.

Each support member 108 may define a transverse cross-section having asubstantially square shape or may define a transverse cross-sectionhaving a circular, oval, rectangular, triangular, polygonal or othershape suitable for supporting a buttress material 300 on a distal end122 of the support member 108. It is contemplated that the transversecross-section of base portion 112 and attachment portion 116 of eachsupport member 108 may be substantially the same or that the baseportion 112 and attachment portion 116 may have different transversecross-sections.

Distal end 122 of each support member 108 may permanently or removablysecure buttress material 300 in place and buttress material 300 may beattached to distal end 122 of each support member 108 by various methodsincluding, for example, adhesives, ultrasonic welding, tacking,stapling, hook and loop, or other methods of attachment which aresuitable to either permanently affix or removably affix buttressmaterial 300 to each support member 108.

As seen in FIG. 6, distal end 122 of each support member 108 may bepositioned at the same radial plane as tissue contacting surface 106 ofstaple cartridge assembly 102 relative to central shaft 110 where, whenbuttress material 300 is affixed or attached to support member 108,buttress material 300 defines a substantially linear radialconfiguration between support 108 and tissue contacting surface 106 ofstaple cartridge assembly 102. It is also contemplated that distal end122 of each support member 108 may be located longitudinally proximal ordistal of tissue contacting surface 106 of staple cartridge assembly102.

Referring now temporarily to FIG. 2, buttress material 300 is generallyannular in shape and includes an inner portion 302, a middle portion304, and an outer portion 306. A substantially centrally locatedaperture 308, defined by the inner circumference of inner portion 302 isformed through buttress material 300. Buttress material 300 may be anyshape sufficient to provide support for anastomosis of tissue aftersurgical stapling device 10 has been fired including, for example, asquare, a circle, an oval, a triangle or any other polygonal or othershape.

In one embodiment, as seen in FIG. 6, buttress material 300 is sizedsuch that when buttress material 300 is affixed or attached to supportmembers 108, outer portion 306 of buttress material 300 extends radiallybeyond staple receiving slots 104 (See FIGS. 3-5) of staple cartridgeassembly 102. Additionally, aperture 308 of buttress material 300 issized to at least receive shaft 204 of anvil assembly 200 therethrough.Aperture 308 of buttress material 300 may also be sized to receivecentral shaft 110 of tubular body portion 100 therethrough. In anotherembodiment, the distance between outer portion 306 of buttress material300 and inner portion 302 of buttress material 300 is substantiallyequal to a width of a tissue contacting surface 106 of staple cartridgeassembly 102.

Each portion 302, 304, and 306 of buttress material 300 may befabricated from surgical grade, biocompatible, non-absorbable material(i.e. permanent) or absorbable material (i.e. non-permanent) mesh ormaterial desirably impregnated with an adhesive, sealant and/or othermedicament. It is also contemplated that each portion may be a compositeof both a non-absorbable and an absorbable material. Suitable materialsfor the fabrication of buttress material 300 and suitable adhesives,sealants, and/or medicaments for impregnation in or application tobuttress material 300 may be found, for example, in U.S. Pat. No.7,942,890, referenced above. U.S. Pat. No. 7,942,890 is herebyincorporated by reference herein, in its entirety.

In another embodiment of the present disclosure, as seen in FIGS. 7-9,an annular surgical stapling device 1000 is disclosed including atubular body portion 1100 which is similar to tubular body portion 100.In this embodiment, a staple cartridge assembly 1102 of tubular bodyportion 1100 includes a central shaft 1110 having a proximal portion1114 with a first smaller thickness and a distal portion 1116 with asecond larger thickness. For example, central shaft 1110 defines aninner diameter which is substantially the same for both the proximal anddistal portions 1114 and 1116 for receiving the shaft 204 of anvilassembly 200. The outer diameter of central shaft 1110 is smaller at theproximal portion 1114 and larger at the distal portion 1116. Thedifference between the inner and outer diameters defines a platform 1120at a distal end 1118 of central shaft 1110 for supporting buttressmaterial 300.

Central shaft 1110 may transition from the smaller outer diameter to thelarger outer diameter gradually along the longitudinal length of centralshaft 1110 where, for example, the outer diameter gradually tapersoutward from proximal to distal, or central shaft 1110 may transitionfrom the smaller outer diameter to the larger outer diameter by definingan arcuate transition portion 1124, as seen in FIGS. 7 and 8. It iscontemplated that central shaft 1110 may have any configuration fortransitioning from the smaller outer diameter at the proximal portion1114 to the larger outer diameter at the distal portion 1116 to increasethe thickness of central shaft 1110 at the distal portion 1116 thereofto provide platform 1120, including, for example, a gentle taperedtransition, an arcuate transition, or a radial extrusion from proximalportion 1114.

Platform 1120 may define any shape suitable for providing an attachmentsurface for securing buttress material 300. For example, platform 1120may be circular, square, rectangular, triangular, oval, starred, spoked,or any other polygonal shape or suitable shape.

As discussed above, buttress material 300 may be attached to platform1120 through any means of attachment or affixation including, forexample, adhesives, ultrasonic welding, tacking, stapling, hook andloop, or other methods of attachment which are suitable to eitherpermanently affix or removably affix buttress material 300 to platform1120. For example, platform 1120 may include attachment points 1122 (SeeFIG. 9) for receiving and securing buttress material 300 to platform1120. It is contemplated that support members, as described above, mayalso be included to assist in supporting and affixing buttress material300. The attachment methods disclosed in U.S. patent application Ser.No. 13/094,893, filed Apr. 27, 2011, may also be used to attach thebuttress material to the support member or platform discussed above.U.S. patent application Ser. No. 13/094,893 is hereby incorporated byreference herein, in its entirety. The buttresses disclosed herein maybe made from the materials disclosed in U.S. patent application Ser. No.13/094,893, filed Apr. 27, 2011. U.S. patent application Ser. No.13/094,893 is hereby incorporated by reference herein, in its entirety.

In another embodiment of the present disclosure, as seen in FIGS. 10-12,a buttress material 3000 is disclosed which is similar to buttressmaterial 300. Buttress material 3000 includes an inner portion 3002, amiddle portion 3004, an outer portion 3006 and defines an aperture 3008therethrough. In this embodiment, aperture 3008 is substantially largerthan central shaft 110 of tubular body portion 100 where, for example,aperture 3008 may have a diameter substantially equal to the innerdiameter of staple cartridge assembly 102. It is contemplated thataperture 3008 may also be smaller than the inner diameter of staplecartridge assembly 102.

Buttress material 3000 is configured for positioning adjacent tissuecontacting surface 106 of staple cartridge assembly 102 and may define adonut like shape which is substantially equivalent in width to the widthof tissue contacting surface 106. It is contemplated that buttressmaterial 3000 may alternatively have a width which is greater than thatof tissue contacting surface 106 and that buttress material 300 mayextend radially outward past tissue contacting surface 106 and/orradially inward towards support members 108 and central shaft 110.

Buttress material 3000 is securable to support members 108 through theuse of a plurality of attachment members 3010 extending from innerportion 3002 into aperture 3008 towards central shaft 110. Attachmentmembers 3010 allow buttress material 3000 to be supported by andattached or affixed to support members 108 with a minimal amount ofmaterial. This reduces overall costs for buttress material 3000 andreduces the force necessary to separate attachment members 3010 from therest of buttress material 3000, during firing by, for example, a knife.Attachment members 3010 may be configured to break away or to be severedfrom buttress material 3000 after or during firing and may includeperforations, shearable sections, or other mechanisms suitable tofacilitating the separation of attachment members 3010 from the rest ofbuttress material 3000.

Attachment members 3010 may be attached or affixed to attachment portion116 of support members 108 in the same manner as described above withregard to buttress material 300 including, for example, adhesives,ultrasonic welding, tacking, stapling, hook and loop, or other methodsof attachment which are suitable to either permanently affix orremovably affix attachment members 3010 to support members 108.

Attachment members 3010 may define a rectangular shape or may defineother shapes including, for example, triangular, square, semicircular,or other shapes suitable for supporting buttress material 3000 andattaching or affixing buttress material 3000 to support members 108 orplatform 1020.

Buttress material 3000 and attachment members 3010 may be made from anyof the materials describe above for buttress material 300 and found inU.S. Pat. No. 7,942,890, referenced above. One or more of inner portion3002, middle portion 3004, outer portion 3006 and attachment members3010 may be made from the same material or one or more of inner portion3002, middle portion 3004, outer portion 3006, and attachment members3010 may be made from different materials.

Turning now to FIGS. 12 and 13, there is illustrated the use of annularsurgical stapling device 10 and detachable anvil assembly 200 in ananastomosis procedure to effect joining of intestinal sections 20 and22. The anastomosis procedure is typically performed using minimallyinvasive surgical techniques including laparoscopic means andinstrumentation. At the point in the procedure shown in FIG. 13, adiseased intestinal section has been previously removed, anvil assembly200 has been applied to the operative site either through a surgicalincision or transanally and positioned within intestinal section 22, andtubular body portion 100 of annular surgical stapling device 10 has beeninserted transanally into intestinal section 20. Intestinal sections 20and 22 are also shown temporarily secured about their respectivecomponents (e.g., shaft 204 of anvil assembly 200, and the tissuecontacting surface 106 of tubular body portion 100).

According to one method, as seen in FIGS. 6, 8, 12, and 13, buttressmaterial 300 may be placed onto support members 108 of tubular bodyportion 100 (or platform 1120 of tubular body portion 1000) prior to thecoupling of anvil assembly 200 to the central shaft 110 of tubular bodyportion 100. Tubular body portion 100 may come with buttress material300 pre-attached to support members 108 (or platform 1120).Alternatively the surgeon may attach buttress material 300 to supportmembers 108 (or platform 1120) prior to use. With buttress material 300secured in place, the surgeon maneuvers anvil assembly 200 until theproximal end of shaft 204 is inserted into the central shaft 110 oftubular body portion 100. Central shaft 110 is now engaged to shaft 204with intestinal sections 20 and 22 disposed between anvil assembly 200and staple cartridge assembly 102. As seen in FIG. 12, for example,buttress material 300 is disposed between cartridge assembly 102 andintestinal sections 20 and 22.

Anvil assembly 200 and tubular body portion 100 are then approximated toapproximate intestinal sections 20, 22 and capture buttress material 300between intestinal section 20 and tissue contacting surface 106 ofstaple cartridge assembly 102. Surgical stapling device 10 is then firedto staple buttress material 300 and intestinal sections 20, 22 togetherand the knife is actuated to cut the portion of tissue and buttressmaterial 300 disposed radially inward of the knife, to complete theanastomosis. For example, the knife may cut through a portion ofbuttress material 300 and may be aligned with perforations or othershearable sections of buttress material 300 to require less force forcutting. Alternatively when a buttress material 3000, having attachmentmembers 3010 is provided, the knife may cut through a portion of eachattachment member 3010 near inner portion 3002 of buttress material 3000where, for example, less force is required to cut through attachmentmembers 3010 than to cut through buttress material 300 because lessmaterial is provided in the path of the knife.

While the use of surgical stapling device 10 has been shown anddescribed, it is understood and within the scope of the presentdisclosure that surgical stapling device 1000 may be operated in thesame or similar manner.

While several configurations of support members and platforms have beenillustrated and described, it will also be apparent that variousmodifications can be made without departing from the spirit and scope ofthe present disclosure. For example, it is envisioned and within thescope of the present disclosure for a greater or smaller number ofsupport members to be provided. It is also envisioned that the spacingof support members from the central shaft may be adjusted and that thespacing or circumferential position of the support members about thecentral shaft may be adjusted. It is also envisioned that a thicker orthinner central shaft with a larger or smaller platform may be provided.

Thus, it should be understood that various changes in form, detail andapplication of the buttress materials of the present disclosure may bemade without departing from the spirit and scope of the presentdisclosure.

1-20. (canceled)
 21. A surgical stapling device for joining tissueportions, comprising: a handle assembly; a tubular body portionsupported on a distal end of the handle assembly, the tubular bodyportion including: a staple cartridge assembly containing a plurality ofsurgical staples in an annular array, the staple cartridge assemblydefining a tissue contacting surface on a distal end thereof; and acentral shaft extending axially through the staple cartridge assemblytowards the distal end of the staple cartridge assembly, the centralshaft including a tissue contacting platform at a distal end thereof,the distal end of the central shaft defining an opening extending atleast partially through the central shaft, wherein the tissue contactingplatform of the central shaft is coplanar with the tissue contactingsurface of the staple cartridge assembly, such that the tissuecontacting platform of the central shaft does not extend beyond thetissue contacting surface of the staple cartridge assembly; an anvilassembly at a distal end of the surgical stapling device, the anvilassembly having a shaft for removably locating the anvil assembly withinthe opening of the central shaft of the tubular body portion, the anvilassembly and tubular body portion being juxtaposed with respect to oneanother along the shaft of the anvil assembly and arranged so as to beapproximated with respect to one another; and a buttress materialsupported by the tissue contacting platform of the central shaft andremovably attached thereto, the buttress material being disposed betweenthe anvil assembly and the staple cartridge assembly.
 22. The surgicalstapling device according to claim 21, wherein the tissue contactingplatform of the central shaft defines a substantially circular platform.23. The surgical stapling device according to claim 22, wherein thecentral shaft defines a proximal portion and a distal portion, thedistal portion having an outer diameter which is larger than an outerdiameter of the proximal portion, the circular platform being disposedon the distal portion of the central shaft.
 24. The surgical staplingdevice according to claim 23, wherein an inner diameter of the proximaland distal portions of the central shaft are substantially the same. 25.The surgical stapling device according to claim 21, wherein a distal endof the central shaft is substantially radially aligned with a distal endof the staple cartridge assembly.
 26. The surgical stapling deviceaccording to claim 21, wherein the staple cartridge assembly defines aninner annular edge and the central shaft defines an outer annular edge,wherein a gap is defined between the inner annular edge of the staplecartridge assembly and the outer annular edge of central shaft.
 27. Thesurgical stapling device according to claim 21, wherein the tissuecontacting platform of the central shaft defines a substantiallypolygonal platform, the buttress material being attachable to thepolygonal platform.
 28. The surgical stapling device according to claim24, wherein a difference in size between the inner and outer diametersof the distal portion of the central shaft defines a size of thecircular platform.
 29. The surgical stapling device according to claim23, wherein the central shaft includes a transition portion between thedistal portion and the proximal portion.
 30. The surgical staplingdevice according to claim 21, wherein the tissue contacting platform ofthe central shaft includes at least one attachment point for receivingand securing the buttress material to the tissue contacting platform.31. The surgical stapling device according to claim 24, wherein theinner diameter of the proximal and distal portions of the central shaftdefine a diameter of the opening of the central shaft.
 32. The surgicalstapling device according to claim 31, wherein the buttress materialincludes an aperture having a diameter that is larger than the diameterof the opening of the central shaft.
 33. The surgical stapling deviceaccording to claim 32, wherein the aperture of the buttress material iscoaxial with the opening of the central shaft when the buttress materialis supported by the central shaft.
 34. The surgical stapling deviceaccording to claim 32, wherein a radial gap is defined between theaperture of the buttress material and the opening of the central shaftwhen the buttress material is supported by the central shaft.
 35. Thesurgical stapling device according to claim 21, wherein the buttressmaterial is positioned proximate to the tissue contacting surface of thestaple cartridge assembly when the buttress material is supported by thecentral shaft.